Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12887-018-1378-2
Title: The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: A prospective cohort study
Authors: Bendabenda, J
Patson, N
Hallamaa, L
Mbotwa, J
Mangani, C
Phuka, J
Prado, E.L
Cheung, Y.B 
Ashorn, U
Dewey, K.G
Ashorn, P
Maleta, K
Keywords: hemoglobin
iron
hemoglobin
iron
age
anemia
Article
body height
child
child development
child growth
child health
cohort analysis
diarrhea
disease association
disease surveillance
emotional stability
female
hemoglobin blood level
high risk population
human
incidence
infant
iron blood level
malaria
Malawian
male
malnutrition
morbidity
motor development
outcome assessment
prevalence
prospective study
respiratory tract infection
social evolution
stunting
anemia
blood
comorbidity
developmental disorder
diarrhea
growth disorder
malaria
nutritional disorder
respiratory tract infection
Anemia
Comorbidity
Developmental Disabilities
Diarrhea
Growth Disorders
Hemoglobins
Humans
Incidence
Infant
Infant Nutrition Disorders
Iron
Malaria
Prevalence
Prospective Studies
Respiratory Tract Infections
Issue Date: 2018
Citation: Bendabenda, J, Patson, N, Hallamaa, L, Mbotwa, J, Mangani, C, Phuka, J, Prado, E.L, Cheung, Y.B, Ashorn, U, Dewey, K.G, Ashorn, P, Maleta, K (2018). The association of malaria morbidity with linear growth, hemoglobin, iron status, and development in young Malawian children: A prospective cohort study. BMC Pediatrics 18 (1) : 396. ScholarBank@NUS Repository. https://doi.org/10.1186/s12887-018-1378-2
Rights: Attribution 4.0 International
Abstract: Background: Although poor complementary feeding is associated with poor child growth, nutrition interventions only have modest impact on child growth, due to high burden of infections. We aimed to assess the association of malaria with linear growth, hemoglobin, iron status, and development in children aged 6-18 months in a setting of high malaria and undernutrition prevalence. Methods: Prospective cohort study, conducted in Mangochi district, Malawi. We enrolled six-months-old infants and collected weekly data for 'presumed' malaria, diarrhea, and acute respiratory infections (ARI) until age 18 months. Change in length-for-age z-scores (LAZ), stunting, hemoglobin, iron status, and development were assessed at age 18 months. We used ordinary least squares regression for continuous outcomes and modified Poisson regression for categorical outcomes. Results: Of the 2723 children enrolled, 2016 (74.0%) had complete measurements. The mean (standard deviation) incidences of 'presumed' malaria, diarrhea, and ARI, respectively were: 1.4 (2.0), 4.6 (10.1), and 8.3 (5.0) episodes/child year. Prevalence of stunting increased from 27.4 to 41.5% from 6 to 18 months. 'Presumed' malaria incidence was associated with higher risk of stunting (risk ratio [RR] = 1.04, 95% confidence interval [CI] = 1.01 to 1.07, p = 0.023), anemia (RR = 1.02, 95%CI = 1.00 to 1.04, p = 0.014) and better socio-emotional scores (B = - 0.21, 95%CI = - 0.39 to - 0.03, p = 0.041), but not with change in LAZ, haemoglobin, iron status or other developmental outcomes. Diarrhea incidence was associated with change in LAZ (B = - 0.02; 95% CI = - 0.03 to - 0.01; p = 0.009), stunting (RR = 1.02; 95% CI = 1.01 to 1.03; p = 0.005), and slower motor development. ARI incidence was not associated with any outcome except for poorer socio-emotional scores. Conclusion: In this population of young children living in a malaria-endemic setting, with active surveillance and treatment, 'presumed' malaria is not associated with change in LAZ, hemoglobin, or iron status, but could be associated with stunting and anemia. Diarrhea was more consistently associated with growth than was malaria or ARI. The findings may be different in contexts where active malaria surveillance and treatment is not provided. Trial registration: NCT00945698 (July 24, 2009) and NCT01239693 (November 11, 2010). © 2018 The Author(s).
Source Title: BMC Pediatrics
URI: https://scholarbank.nus.edu.sg/handle/10635/181167
ISSN: 14712431
DOI: 10.1186/s12887-018-1378-2
Rights: Attribution 4.0 International
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